January 19, 2023

1.4 Million Medicare Beneficiaries Receive No Cost Over-The-Counter COVID-19 Tests in the Second Quarter of 2022

An analysis of Medicare claims data by McDermott+Consulting shows that 10.6 million at-home COVID-19 tests were distributed to 1.4 million Medicare beneficiaries from April through June of 2022. During this time, the number of tests distributed and the number of beneficiaries receiving them increased each month with the largest influx in tests occurring between April and May 2022. Tests were distributed across all 50 states plus the District of Columbia and Puerto Rico, reaching almost 1.3 million beneficiaries living in urban areas and 130,000 rural beneficiaries.

Table: Medicare Fee-for-Service Volume for At Home Covid-19 Tests

Pharmacies (including the large national chains) distributed 96% of tests.

“Our data shows that there was a high and growing demand for easy access to at-home COVID-19 tests, and that the Biden Administration’s demonstration provided a meaningful benefit to our nation’s seniors,” said Amy Kelbick, a lobbyist representing the Testing at Home Coalition.

The Medicare demonstration program to cover at-home tests at no-cost to beneficiaries is expected to end when the COVID-19 public health emergency (PHE) ends. Congresswoman Anna Eshoo, Ranking Member of the House Energy and Commerce Health Subcommittee, and AARP both sent letters to CMS expressing their support for the program and asking for details on CMS’s authority and plans to continue to make free at-home tests available to Medicare beneficiaries beyond the PHE. A copy of those letters can be found here and here.

Additional Background Information:

On April 4, 2022, the Biden-Harris Administration announced that Americans with Medicare Part B, including those enrolled in a Medicare Advantage plan, would have access to Food and Drug Administration approved, authorized, or cleared over-the-counter COVID-19 tests at no cost.

This marked the first time in history where Medicare has paid for an over-the-counter product. The initiative allows these beneficiaries to have access to up to eight tests per month, at no cost, from participating and eligible pharmacies or health care providers.

The Centers for Medicare and Medicaid Services established this program using authority available to the agency through 42 U.S. Code § 1395b–1, which authorizes the agency to, among other things, develop and implement projects to test new Medicare payment methods.

This demonstration began April 4, 2022 and will continue until the COVID-19 public health emergency ends, unless extended by the Centers for Medicare and Medicaid Services.